1121. Pediatric Urgent Care Providers’ Approach to Antibiotic Stewardship: A National Survey

Abstract

BackgroundA high proportion of urgent care visits are for acute infectious conditions. Emerging data have shown that outpatient antibiotic prescribing for acute respiratory conditions is highest in urgent care settings; however, this has not been specifically studied among pediatric urgent cares. The objective of this study was to survey pediatric urgent care providers about their approach to antibiotic stewardship.MethodsMembers of the Society for Pediatric Urgent Care were recruited via e-mail to participate in a quality improvement antibiotic stewardship project. A pre-implementation survey developed by study investigators was piloted with several pediatric urgent care physicians and revised based on feedback. The finalized REDCap survey was sent to participants via e-mail in March 2019. Descriptive statistics were used to analyze the survey responses.ResultsA total of 156 providers completed the survey; 83% were board-certified pediatricians. Almost all (98%) indicated that antibiotic stewardship programs are important to optimize antibiotic use in urgent care. Just over half (53%) indicated that their urgent care center provides guidelines for prescribing antibiotics for acute respiratory tract infections. Treating patients with an underlying complex medical condition was the most common reason (21%) providers would deviate from guidelines. The most commonly cited barriers to appropriate prescribing for acute respiratory infections were patient expectations (93%), psychosocial barriers (40%), lack of clear evidence-based recommendations (15%), and lack of access to guidelines on prescribing (15%).ConclusionMost pediatric urgent care providers feel that antibiotic stewardship is important and would not impede their clinical approach. Parental expectations of receiving antibiotics were viewed as the most common barrier to appropriate prescribing. This work will be used to promote directed interventions to improve appropriateness of antibiotic prescribing for target diagnoses in pediatric urgent care centers.Disclosures All authors: No reported disclosures.